Hi. This is, LaTrice Jeter, and I’m the owner of Simplified Insurance Solutions, and this is your Assistive Technology Update.
Hello and welcome to your Assistive Technology Update, a weekly dose of information that keeps you up to date on the latest developments in the field of technology designed to assist individuals with disabilities and special needs. I’m your host, Josh Anderson, with the Indata Project at Easterseals Crossroads in beautiful Indianapolis, Indiana. Welcome to episode 636 of Assistive Technology Update. It’s scheduled to be released on August 4th, 2023.
Our guest today is, Latrice Jeter, from Simplified Insurance Solutions, and she’s here to discuss how she helps people find benefits that they may be missing out on. Latrice, welcome to the show.
Thank you so much for coming on. Before we get into talking Insurance and the different kind of solutions that Simplified Insurance Solutions offers, could you tell our listeners a little bit about yourself?
Sure. So my name is, Latrice Jeter. And again, I’m the owner of the Medicare brokerage, Simplified Insurance Solutions. And I live here locally in Indianapolis, Indiana, myself and my daughter, and we have a couple dogs.
The real reason we had you on was to talk about Simplified Insurance Solutions. Can you start off by just telling us what is it?
So Simplified Insurance Solutions is a one stop shop, I like to say, when it comes to Medicare offerings. So we offer Medicare Supplement Plans, Medicare Advantage Plans, prescription drug plans, and then we have ancillary benefit offerings as well that are tailored to seniors and those with disabilities such as final expense and hospital indemnity, dental, vision and hearing products. Most of the gamut of the product offerings.
Now for folks who haven’t really had to deal with Medicare and things like that, I know it can get very confusing. But could you just give us an overview of what supplemental insurance is and how it helps?
Sure. So a Medicare Supplement Plan is… and there’s two types of plan offerings that one can choose to utilize in addition to Medicare. One of them is a Medicare Supplement Plan, also known as a Medigap Plan. And this is just a policy that would pay after original Medicare pays. So if someone’s original Medicare A and B, they automatically qualify as well for a Medicare Supplement Plan when they’re first qualifying for Medicare, that would be the first six months that they have Medicare. And then after that, there are certain people who qualify, some qualify, some don’t. Based on different health reasons or the qualifiers.
And then there’s another type of plan that supplements Medicare, however, it’s called a Medicare Advantage Plan. And with the Medicare Advantage Plans, those plans pay instead of Medicare. And so they also include additional benefits that a traditional Medicare Supplement Plan wouldn’t include, such as the dental, the vision, the hearing, the prescription drugs, the part A and part B coverage all enrolled into that one plan through a private carrier as well, just like Medicare supplement. So those are the two main options that they have to supplement their original Medicare A and B and help to lower some out- of-pocket costs.
When you’re working with someone, how do you make sure that they’re getting what’s best for them and what’s going to help them out the most? What does that process kind of look like?
Yeah, that’s a great question. So our top priority with anyone that we meet with all of our clients is educating them. And so we start any meeting with a client just with the Medicare 101. And so we’re basically covering exactly how Medicare Part A works, how part B works, how part C works, which is a Medicare Advantage Plan as well as Part D, prescription drug plans. And then we go into much more detail to compare for them the Medicare supplemental offerings and qualifications for those, versus a Medicare Advantage Plan and the qualifications of those.
We then go through a needs analysis with the client so that we can determine what all do they qualify for and more importantly, how can we help them to lower their out-of-pocket costs even more than however low it is at that time. So at that point we then, after qualifying them, there’s a lot of different plan offerings out here or benefit offerings I should say, that the general public is just not aware of and so we want to educate them on those benefits as well.
Most people think of Medicare and they just think of the federal government, however many seniors and those with disabilities often also qualify for Medicaid benefits as well. So we educate them on that, how Medicare and Medicaid, if they do qualify for both, will coordinate benefits. We will assist them with guiding them through those processes if they don’t have Medicaid of assisting them with getting in touch with the appropriate contacts to apply for Medicaid.
And then if they do qualify for Medicaid as well as Medicare, there’s additional programs that they may qualify for such as low income subsidy programs and extra help to significantly reduce, or even take their prescription drug cost to zero. There’s veteran benefits and programs that many are not aware of that we can couple up with Medicare and Medicaid to again lower their out-of-pocket costs significantly.
And then there’s also with Medicaid and Medicare, if they qualify for both, then they become dual eligible. And being dual eligible simply means you have both Medicare through the federal government as well as Medicaid, the state program for assistance. That qualifies them for a dual special needs plan. So then that comes with even more benefits and zero out of pocket to them for all of those benefits.
So I can go on and on, but there’s a lot of programs out there. Just to give you an idea, those are just four of the top ones that we discuss with clients most often that many qualify for, and they just don’t realize that they qualify for it. And unfortunately the government typically won’t proactively reach out to a beneficiary, a Medicare beneficiary and just say, “Here’s one letter. You qualify for these five things.” Which would keep it simple and then they could just apply, apply, apply.
But it just doesn’t work that way, random letters from all these different departments. It’s very confusing for those with disabilities. And so we’re there to walk them through those processes and keep it simple for them.
Well, that’s awesome. And you said something very important there that you’re getting letters from different agencies about what you may qualify for. The wording’s never the same if it’s even easy to understand for anyone. And if you go out looking for that information, it seems as if it’s scattered across 20 different agencies, in 10 different places, but it’s like it’s hidden. You almost really have to dig to find it. So that that’s great that you walk along that journey with them and find out what they need and where they’re sitting and then let them know all those options. And then from there they make the decision on their own which way to go. Is that right?
That’s correct, yes. We make sure that by the end of our meeting with them, even if it takes a couple appointments, or a few appointments with them, that they have benefits that they qualify, that they’re educated on why they qualify for those benefits, how to maintain those benefits, who to contact if they have questions about those benefits. And our services are no charge, at all. So we truly do streamline the entire process for them and walk them through it, and then we remain available to them. We don’t just go away after those meetings.
So if there’s any confusion, any confusing letters that show up because many come in the mail, they can contact us from there on out for assistance and have a person that they can call that they know they can actually reach. And it’s going to be consistent information, it’s going to be accurate information, and you’re not calling, pushing all the buttons, listening to all the prompts going through service centers to get transferred over and over in the call center.
So it’s very beneficial still to still have a local agent or agency that one works with. We happen to be a brokerage, and so we represent the major carriers, the national carriers, as well as the large regional carriers, many of even the small carriers here throughout the state so that we have plenty of benefit options available for them and plan options.
Well, that’s great. And you mentioned just the confusion sticking with the folks, because I know for a lot of folks, especially if you have both coverages, you may go to the hospital and maybe one went through, but the other one hasn’t yet, and the hospital sends a bill, “Do I pay it? Does this need to go to this, does need to go there?”
And it’s confusing and you hit the nail on the head and I can’t remember what I’ve tried to get fixed before, but you call and you have that great customer service person on the phone and they’re helping you, and then you have to call back and that person can never get on the phone again. And so just having the advocate there, the person that can not just explain the things to you but know a little bit about you and be able to walk you through that process, just gives you so much more peace of mind.
Correct, yes. And the other thing, when you’re just calling in and going through the prompts, oftentimes with our clients, we hear a lot of their frustration is, “Each time I call, I get a different answer. Not only is it a different person, it’d be a totally different answer to the exact same question.” So that’s very frustrating and confusing. So it is nice, yes, to have someone local to help out.
Yeah. I have to ask you, and this is just an opinion, but why do you think it’s so hard for individuals to find all the benefits and programs that they qualify for?
I would say there’s a lot of misinformation out there floating around, and the Centers for Medicare and Medicaid services, they try to stay on top of it because there’s so much information out there floating around. I come across misinformation myself personally, often. I just randomly see things. I’ve been in this industry over 20 years, so many articles come to me, you know how I have my notifications of reputable sources, and then I see a lot of other sources out there that look reputable, appear to be reputable, and I read the information and it’s complete misinformation.
So that’s one piece is there’s quite a bit of misinformation floating around out here. The other piece is if it is accurate, it’s very confusing. Our insurance jargon, the language that we speak can be very confusing. It’s like what is a deductible actually? Many people have heard these terms, but they’re not actually familiar with, “How does that actually apply to me and my family and these bills and these claims that I’m submitting.”
Even just the terminology and the jargon that comes in the mail to them that they see on TV can be confusing. And then it’s also just, in my personal opinion, I don’t want to say a lack of keeping beneficiaries informed, there really is. And that comes from the state departments, from HHS, from CMS. They’re sending all this information out, but it’s very confusing because like I said, it’s so many different departments, so many different programs. Like you said, “What do I qualify for? What do I not?”
I know if I didn’t look at this stuff all day, every day and talk insurance daily, I would be as comfortable as I am with it. So we go through a lot of training, even for us as agents and brokers, we’re constantly taking certifications, re-certifications, licensing courses, and the information is constantly changing. That’s the other thing is what applies in 2022 doesn’t apply for 2023 a lot of times. What applies for this year may not apply for next year.
So it’s also just staying up to date on what is current with all of these different benefits and programs and plans, it all changes nonstop. So that’s another piece of it. We’re working with those with disabilities often, and so are they receiving their communications in an accessible format. At times They are not receiving it in an accessible format, and they’re not aware that they’re absolutely available to them in accessible formats, and so we also even assist them with that. But we can get any communications that they receive sent to them in braille, in large print and audio, for example. Yeah, I would say those things combined are what makes it tough and why it is nice to have advocates like us and people there to assist.
What’s something that people should look out for, and I know it’s impossible to get rid of all the misinformation, not just insurance but in everything out there these days. But is there something people should look out for just to make sure that they are getting good information and not fall into that trap of misinformation?
Sure. I would say the most reputable sites are to actually go to those government sites because there are other sites floating around out here. But if you actually go to HHS to Health and Humane Services, if you actually go to CMS, the Centers for Medicaid and Medicare services, that actual website. Go out to medicare.gov, just the original Medicare website. The government, what they have done with those websites is make them very organized and quite easy to navigate.
Now, once you get there, it could be information overload of where do I go. Again, we navigate these sites all day, every day. So I’m going to notice, “Wow, this is organized very nicely.” If I were just jumping in there once every four or five years, it might not look as simple to me. So the one thing that I always recommend is go directly to the source.
So any information that they’re getting, if someone has Medicare, you have CMS codes on it, you have HHS codes on it. If it’s a letter, if it’s a piece of mail, if it’s a flyer, if it’s a brochure, if it is reputable, it always has a code in the bottom left or right corner on either the front or back. It’s going to indicate something like CMS or HHS or SSI or SSDI, even if it’s the social security site or the SSDI site. And so that can indicate for them, “Oh, okay, this is the department it’s coming from.”
If they want more information, I’ll always recommend call the number on that letter versus just Googling and calling around. That’s what I would recommend is just make sure that you’re at a reputable website or government site.
Excellent. I think that’s great advice. LaTrice, can you tell us a story about someone who was able to become more independent and maybe gain access to different things that they qualified for through your services?
Oh, absolutely. Sure. Oh, where do I start? That’s dating-
Well, maybe just a couple words where it’s easy to not accidentally disclose something.
So just as an example, and this is actually common. Someone will schedule a meeting with me and the things that I always have any client bring to the meetings, I tell them, gather every insurance card that you have that’s current and active in force. Bring a list of all of your doctors, bring a list of all of your prescriptions, the dosage, frequency, and quantity.
And then what we’re doing through that process is entering that stuff in the system. We search the networks for them, make sure they can still see all their doctors and specialists. We go through all the different benefits if they have questions. So a lot of these meetings are general question meetings like, “This is everything I have. I believe I have enough coverage and I believe I have everything I qualify for.” And we’re just confirming that for them and pointing out to them, “Did you realize that you have these 35 benefits that you haven’t been using?”
A lot of our disabled clients and seniors, they have a lot of benefits already and they’re just, again, not aware of it because they get bombarded with information coming into them not knowing what applies to me and what actually doesn’t to my specific plans that I have, versus all of this general information that has nothing to do with me. It’s hard to discern that sometimes. A client, I can think of one earlier this week, he happened to come in with just an original Medicare card, part A and B when we first met. And after discussing with her and just going through a basic needs analysis, we determined that it sounded like she may qualify for Medicaid as well as a Medicaid waiver, as well as the low income subsidy here in the state of Indiana.
Once she had Medicaid and that low income subsidy at the level that they qualified her for, it also qualified her for a dual special needs plan. And so she went from thousands of dollars out of pocket, when we met again this week, just original Medicare to an effective date of June 1st. Now she’ll have the dual special needs plan. She’ll have a low income subsidy, so her prescription cost went from hundreds of dollars a month for her to zero.
Her copays and deductibles and out-of-pocket costs went from thousands of dollars a year for her to zero. So just examples like that, again, where she qualified for a lot of benefit programs, but she simply wasn’t aware that she qualified for them. So that’s one of those examples where it took a couple meetings, but as of this week, we were finally able to go ahead and get her enrolled in the dual special needs plan because she taken the prior steps that we requested of her so that she had all the benefit programs that would qualify her for that dual special needs plan.
And now we’re able to help her with her out-of-pocket costs because they all went to zero with allowances or very low copays for some services. But the majority of them that she needed assistance with went to zero. So that’s the ways that we can help out with regard to our services. Tying specifically into things like assistive technology, we’re helping clients regularly that need durable medical equipment. Things such as wheelchairs and oxygen, beds that lift up, canes, pumps, things like that, that they need help with to live independently in their homes and comfortably.
And so we can get them on programs a lot of times if they qualify where that becomes zero out-of-pocket for them. So it goes from, “I’m concerned about if I’m going to be able to afford this.” To, “You don’t have a charge for it at all.” After we get them enrolled in what they qualify for.
Many of the plans include extra benefits beyond just simple medical services, such as covering them for hearing aids, for glasses, contacts, and these are at zero copays. They qualify to become dual for transportation. They’ll include transportation benefits, and that’s something that clients will, if I’m on the phone with someone and they’re telling me, “Well, I’m going to take the bus to get there, I’m looking for a ride.”
I’m taking notes from the initial call, so I need to find them a transportation benefit. There’s allowances for assistive devices and safety devices such as handrails, shower stools, raised toilet seats, mobility ramps. We have discussions with clients and find that out. And there’s a lot of different programs out here where we could either get the cost significantly lowered and affordable for them, or even take it to a zero cost because that as well was covered on the dual special needs plans.
They get things like health and fitness trackers at no cost to them, in-home support with independent activities and daily living, like light chores and errands and laundry, things like that. If they need technology assistance. Sometimes I talk with clients and they’re frustrated with their cell phones or I say, “Do you want to do this application online or would you prefer face-to-face?” And they say, “Oh, I don’t even understand this laptop. I got it for Christmas a couple of years ago and it’s frustrating to me.” So things like that we’re taking notes on because there are programs out here where they can have that in-home support for independent living and not be paying for it at all if they qualify.
They’re spending allowances for their utilities for over the counter benefits for durable medical equipment. And when I say spending allowances, it can be, “Here’s a $3,000 benefit for the year.” Or the dollars per month of a benefit, and then they can use it towards what they need to. And those are just random amounts and samples but they’re realistic of the types of benefit that we’re signing them up for.
It covers diabetic supplies, things such as their insulin pumps and prosthetics, artificial limbs, braces, aesthetic devices, orthotic devices. A lot of times we have clients that are looking at beginning rehab and therapy and it’s not affordable for them. And so if they qualify with disabilities, there’s a lot of programs that will actually cover those outpatient rehab services like cardiac, pulmonary, occupational therapy, speech therapy, and that list goes on.
So personal emergency response systems are included in these plans, the device, the installation, and the monitoring for those that are high risk, high risk medically and/or high risk for falls. They get annual allowances, even some of these programs for service dog support. So the leashes, the pet supplies up to maybe 500 or a thousand a year depending on which plan and benefit it is that we enroll them in, that they qualify for.
Things to try to stay healthy and active, such as gym memberships are included in many of the plans for dual special needs or Medicare Advantage Plans. So I could go on and on. It is just a wealth of benefits that if we can qualify them, they can have access to and either lower their cost significantly or just take them to zero. And that’s the goal, is to get it as low as possible.
And that’s so great, and you brought up so many things that affect a lot of the folks that our listeners, they’re friends, they’re family, and I mean a lot of the folks that we work with as well. And in the world of disability and in aging, there’s scary things out there, especially when you find out you need some of the things that you mentioned, any of those things. But the fact that there’s programs out there built to help people, and a lot of times I know the money just sits there. No one knows it exists, or they don’t know how to qualify, or they don’t know how to get into it.
And like you said earlier, all that stuff’s kind of fractured. It’s hard to find it all. So that’s great that you’re providing that service to be able to help folks put it all together. And, LaTrice, talking about that and putting it all together, how can our listeners find out more?
Oh, thank you. Well, to contact us, we do have a website that is simplifiedinsurancesolution.com. And then our TOLLFREE number, they can call anytime, is (888) 340-7633. And then my personal cell number, if they want to speak with me personally is (317) 213 1091.
We will put that all down in the show notes and, LaTrice, thank you so much for taking time out of your day to tell us about them and taking the time to actually help people navigate through this and really and truly be able to access the help that they really need to make a big difference in their life and their independence.
Thank you for having me as a guest, Josh. I appreciate it.
Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on an Assistive Technology Update? If so, call our listener line at (317) 721-7124. Send us an email at email@example.com or shoot us a note on Twitter at INDATAproject. Our captions and transcripts for the show are sponsored by the Indiana Telephone Relay Access Corporation or INTRAC. You can find out more about INTRAC at relayindiana.com.
A special thanks to Nikol Prieto, for scheduling our amazing guests and making a mess of my schedule. Today’s show was produced, edited, hosted, and fraught over by yours truly. The opinions expressed by our guests are their own and may or may not reflect those of the Indata Project, Easterseals Crossroads, our supporting partners or this host. This was your Assistive Technology Update, and I’m Josh Anderson with the Indata Project at Easterseals Crossroads in beautiful Indianapolis, Indiana. We look forward to seeing you next time.